中国人群中久坐时间与全因死亡及心血管疾病的关联

doi:10.16352/j.issn.1001-6325.2025.11.1438

基础医学与临床 ›› 2025, Vol. 45 ›› Issue (11): 1438-1443.doi: 10.16352/j.issn.1001-6325.2025.11.1438

中国人群中久坐时间与全因死亡及心血管疾病的关联

兰磊¹, 郎欣月¹, 陈飞龙², 王慧³, 何国敏⁴, 李卫², 刘之光^1*, 代表前瞻性城乡流行病学研究中国地区协作者

1.首都医科大学附属北京安贞医院药事部临床试验机构,北京 100029;
2.中国医学科学院北京协和医学院国家心血管病中心阜外医院医学统计部,北京 102308;
3.和田区疾病预防控制中心,新疆和田 848099;
4.勐腊县疾病预防控制中心,云南西双版纳 666399

收稿日期:2024-12-26 修回日期:2025-02-26 出版日期:2025-11-05 发布日期:2025-10-24
通讯作者: ^*liuzhiguang@anzhengcp.com
基金资助:
国家心血管疾病临床医学研究中心·深圳自主课题(NCRCSZ-2023-012)

Association of sitting time with all-cause mortality and cardiovascular disease in the Chinese population

LAN Lei¹, LANG Xinyue¹, CHEN Feilong², WANG Hui³, HE Guomin⁴, LI Wei², LIU Zhiguang^1*, on behalf of PURE-China investigators

1. Department of Pharmacy and Clinical Trial Unit, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029;
2. Medical Research and Biometrics Center, Fuwai Hospital, National Center for Cardiovascular Diseases, CAMS & PUMC, Beijing 102308;
3. Hetian District Center for Disease Control and Prevention, Hetian 848099;
4. Mengla County Center for Disease Control and Prevention, Xishuangbanna 666399, China

Received:2024-12-26 Revised:2025-02-26 Online:2025-11-05 Published:2025-10-24
Contact: ^*liuzhiguang@anzhengcp.com

摘要/Abstract

摘要： 目的使用前瞻性城乡流行病学(PURE)研究的数据,探索在中国人群中久坐时间与全因死亡和心血管疾病(CVD)的关系。方法依托前瞻性城乡流行病学中国地区(PURE-China)队列研究,自 2005—2009 年通过标准化问卷及体格检查对受试者进行基线调查,并随访至2022年8月31日,主要研究终点为全因死亡和CVD(非致死性心肌梗死、卒中或心力衰竭)。通过多因素Cox共享脆弱模型分析中国人群中久坐时间与全因死亡及CVD风险的关联,并比较在不同性别、年龄和城乡中的关联差异。结果本研究共招募 47 931名参与者,最终43 367名纳入分析。平均随访(11.9±3.0)年,共2 277例参与者发生全因死亡事件,3 551例参与者发生CVD。多因素Cox共享脆弱模型表明,相较于久坐小于4 h的人群,久坐时间6~8 h全因死亡风险增加23%(HR=1.23,95% CI:1.06~1.44),CVD风险增加18%(HR=1.18,95% CI:1.04~1.33);久坐时间8 h以上全因死亡风险增加50%(HR=1.50,95% CI:1.16~1.94),CVD风险增加44%(HR=1.44,95% CI:1.16~1.79)。在男性和年龄50岁以上人群中这种关联更加明显。结论中国人群中久坐与全因死亡及心血管疾病的风险增加有关,尤其是久坐6 h及以上。减少久坐时间和增加体力活动可能是减轻心血管疾病负担和过早死亡的重要策略。

关键词: 久坐, 心血管疾病, 队列研究, 全因死亡, 风险比

Abstract: Objective To explore potential association between sedentary time and the risk of all-cause mortality and cardiovascular disease (CVD) in Chinese population using data from the Prospective Urban Rural Epidemiology (PURE-China) cohort study. Methods Baseline data were collected, from 2022 standardized questionnaires and physical examinations, with follow-up until August 31, 2022. The primary endpoints were all-cause mortality and cardiovascular events (non-fatal myocardial infarction, stroke or heart failure). Multivariable Cox shared frailty model was used to analyze the association between sedentary time and the risks of all-cause mortality and CVD in the target population, and to compare differences across subgroups based on gender, age and geographic location. Results A total of 47 931 participants were recruited, and 43 367 were included in the final analysis. Over a median follow-up of 11.9±3.0 years, 2 277 participants experienced all-cause mortality, 3 551 experienced cardiovascular events. The Cox model indicated that, compared to individuals with less than 4 h of sedentary time per day, those with 6-8 h had a 23% increased in risk of all-cause mortality (HR=1.23, 95% CI: 1.06-1.44) and an 18% increased risk of CVD (HR=1.18, 95% CI: 1.04-1.33). For individuals with more than 8 h of sedentary time, the risk increased by 50% for all-cause mortality (HR=1.50, 95% CI: 1.16-1.94) and 44% for CVD(HR=1.44, 95% CI: 1.16-1.79). These associations were more pronounced in men and individuals aged 50 years and older. Conclusions Sedentary behavior is associated with an increased risk of all-cause mortality and cardiovascular disease in Chinese population, especially in the population with sedentary time of 6 hrs or more per day. Reducing sedentary time and increasing physical activity is an important strategy to mitigate the disease burden of cardiovascular disease and premature death.

Key words: sedentary behavior, cardiovascular disease, cohort study, all-cause mortality, hazard ratio

中图分类号:

R181

兰磊, 郎欣月, 陈飞龙, 王慧, 何国敏, 李卫, 刘之光, 代表前瞻性城乡流行病学研究中国地区协作者. 中国人群中久坐时间与全因死亡及心血管疾病的关联[J]. 基础医学与临床, 2025, 45(11): 1438-1443.

LAN Lei, LANG Xinyue, CHEN Feilong, WANG Hui, HE Guomin, LI Wei, LIU Zhiguang, on behalf of PURE-China investigators. Association of sitting time with all-cause mortality and cardiovascular disease in the Chinese population[J]. Basic & Clinical Medicine, 2025, 45(11): 1438-1443.

参考文献

[1] Li S, Lear SA, Rangarajan S, et al. Association of sitting time with mortality and cardiovascular events in high-income, middle-income, and low-income countries[J]. JAMA Cardiology, 2022, 7:796-807.
[2] Ng SW, Popkin BM. Time use and physical activity: a shift away from movement across the globe[J]. Obes Rev, 2012, 13:659-680.
[3] Bull FC, Al SS, Biddle S, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour[J]. Br J Sports Med, 2020, 54:1451-1462.
[4] Piercy KL, Troiano RP, Ballard RM, et al. The physical activity guidelines for Americans[J]. JAMA, 2018, 320:2020-2028.
[5] Gibson H. UK Chief Medical Officers' physical activity guidelines 2019: What's new and how can we get people more active?[J]. Nutrition Bulletin, 2019, 44:320-328.
[6] Lang X, Liu Z, Islam S, et al. Interaction of depression and unhealthy diets on the risk of cardiovascular diseases and all-cause mortality in the chinese population: a PURE cohort substudy[J]. Nutrients, 2022, 14. doi: 10.3390/nu14235172.
[7] Dagenais GR, Leong DP, Rangarajan S, et al. Variations in common diseases, hospital admissions, and deaths in middle-aged adults in 21 countries from five continents(PURE): a prospective cohort study[J]. Lancet, 2020, 395:785-794.
[8] Carter S, Hartman Y, Holder S, et al. Sedentary behavior and cardiovascular disease risk: mediating mechanisms[J]. Exerc Sport Sci Rev, 2017, 45:80-86.
[9] Restaino RM, Holwerda SW, Credeur DP, et al. Impact of prolonged sitting on lower and upper limb micro- and macrovascular dilator function[J]. Exp Physiol, 2015, 100:829-838.
[10] Howard BJ, Balkau B, Thorp AA, et al. Associations of overall sitting time and TV viewing time with fibrinogen and C reactive protein: the AusDiab study[J]. Br J Sports Med, 2015, 49:255-258.
[11] Stamatakis E, Hamer M, Dunstan DW. Screen-based entertainment time, all-cause mortality, and cardiovascular events: population-based study with ongoing mortality and hospital events follow-up[J]. J Am Coll Cardiol, 2011, 57:292-299.
[12] Bakker EA, Hartman YAW, Hopman MTE, et al. Validity and reliability of subjective methods to assess sedentary behaviour in adults: a systematic review and Meta-analysis[J]. Int J Behav Nutr Phys Act, 2020, 17:75. doi: 10.1186/s12966-020-00972-1.

[1]	胡艳敏, 彭丽娜, 杨勇, 向韵瑄, 常晓悦. Pleckstrin同源域家族A成员1在代谢性疾病中的作用[J]. 基础医学与临床, 2025, 45(2): 268-272.
[2]	杨剑锋, 郝琳, 王岩, 冀全博. 骨关节炎与心血管疾病交互影响的研究进展[J]. 基础医学与临床, 2025, 45(2): 148-153.
[3]	唐丽鸿, 陈春玲. SphK/S1P在心血管疾病中的作用[J]. 基础医学与临床, 2024, 44(8): 1175-1179.
[4]	高源, 郑刚, 齐靖, 张凤. NLRP3炎性小体在心脏病发病中的作用研究进展[J]. 基础医学与临床, 2023, 43(7): 1162-1166.
[5]	杜丰禾, 刘暴. 血管周围脂肪组织炎性反应促进动脉粥样硬化作用机制的研究进展[J]. 基础医学与临床, 2023, 43(4): 685-689.
[6]	沈霞芬, 蔡强, 俞蔚, 许晓辉. 心血管疾病高危人群的影响因素及其关联分析[J]. 基础医学与临床, 2023, 43(11): 1655-1661.
[7]	马茜钰, 彭石, 张兆元, 张丹, 张锦. 盐皮质激素受体对心血管疾病影响的研究进展[J]. 基础医学与临床, 2022, 42(8): 1292-1296.
[8]	刘延丽, 赵瑞雪, 潘燕, 马雅军, 赵暾, 蒋晓燕, 李淑娟. 抑郁症状增加中国老年人跌倒风险[J]. 基础医学与临床, 2022, 42(6): 945-949.
[9]	胡诗琪, 蓝彦琦, 吴寿岭, 王晓墨, 陈朔华, 汪国栋, 王丽. 肥胖及其变化对中国华北新发NAFLD成年男性患者心血管疾病发病风险的影响[J]. 基础医学与临床, 2022, 42(5): 788-794.
[10]	梁清, 陈丽红. 生物钟紊乱致心脏功能障碍的研究进展[J]. 基础医学与临床, 2022, 42(5): 799-803.
[11]	吴岳恒, 余细勇. 人工智能在心血管疾病研究和临床中的应用[J]. 基础医学与临床, 2022, 42(11): 1644-1649.
[12]	袁景林, 赵瑞雪, 李晓东, 蒋晓燕, 王笑峰, 周晓梅, 李淑娟. 运动认知风险综合征增加老年人住院风险[J]. 基础医学与临床, 2021, 41(8): 1169-1173.
[13]	黄仙, 吴寿岭, 陈朔华, 孙园园, 张迪, 郭淑霞, 王丽. 全血铁和铜与心血管疾病关联的基于队列的病例对照研究[J]. 基础医学与临床, 2021, 41(5): 709-714.
[14]	袁玲, 聂卫, 王蕾, 王宏, 崔晓雪, 刘琳娜. 慢性肾脏病血管钙化大鼠并发心肌炎性反应[J]. 基础医学与临床, 2021, 41(2): 197-202.
[15]	时英, 郭永芳, 邓玉婷, 戴红艳, 管军. Salusin-β在心血管疾病中作用的研究进展[J]. 基础医学与临床, 2021, 41(2): 282-286.

中国人群中久坐时间与全因死亡及心血管疾病的关联

Association of sitting time with all-cause mortality and cardiovascular disease in the Chinese population

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价